OBR Daily Commentary

forumImage

Potential Administrative Burdens in Oncology Clinical Pathways

(Journal of Clinical Pathways) May 7, 2018 - A recent review of prominent pathway vendors revealed that most vendors met the key ASCO criteria for being expert-driven, patient-focused, up to date, and comprehensive.

Read Article arrow

William McGivney, PhD (Posted: May 11, 2018)

quotesCoincidently, I was lecturing last week at the Home of Guideline study, Dartmouth (at the Tuck Business School). I talked about how studies in the 1980s by Drs Wennberg, Zubkoff, and others argued for the establishment of national guidelines. Why? The goal was to diminish the substantial variation of physician practice and recommendations for different reasons in regions across the country. Thirty years later, we now have a (dare I say) bastardization of that principal as described in this article. Payers, health plans, MCOs, etc. require their own selected and favorite pathways that may differ across each patient frequently in terms of recommended treatments, including preferred treatments. Oncology practices must juggle multiple, disparate recommendations depending on the insurance that a patient may carry or that MCO picked by a payer to manage that patient. The circumstance of the multiple guideline/pathways recommendations that oncology practices have to juggle belies the concept of a National Guideline that unifies and directs best patient care. Anybody ever hear of the letters NC? quotes

Add Comment 1 Comment
forumImage

Women With Breast Cancer Delay Care When Faced With High Deductibles

(New York Times) May 4, 2018 - When people must pay thousands of dollars before their insurance kicks in, studies show, they postpone necessary tests and treatments.

Read Article arrow

William McGivney, PhD (Posted: May 11, 2018)

quotesPayer cost-sharing requirements for patients are an anathema, abomination and disgrace all rolled into one. The current story reiterates, yet again, the issue of seriously ill patients delaying or forgoing needed treatment because of cost-sharing terms in their insurance plan. Cost-sharing is such a nice, euphemistic way to describe what is the abhorrence of this insurer patient-gouging strategy. Indeed, as I am wont to ask, is there still really health insurance that protects seriously ill patients from catastrophic events? If there is, it is “slip, slip sliding away” as commercial payer revenue keeps rising. The solution is legislation that would eliminate on the private payer side and public payer side cost-sharing arrangements such as deductibles, co-insurance, and co-pays for those diagnosed with and battling serious life-threatening illnesses. A list of such illnesses should be delineated that deserve such protection to assure patient access to necessary therapies. I developed the Terminal Illness program that Aetna instituted in 1992. To establish a solid patient-oriented and humane piece of legislation is a relatively easy “to do”. Then, we can see who truly stands in support of patients! We should move forward as we seek to serve and treat seriously ill patients in need! quotes

Add Comment 1 Comment
forumImage

Here’s What We Actually Know About The Amazon, Berkshire And J.P. Morgan Health Initiative (Hint: Very Little)

(MarketWatch) Feb 5, 2018 - Health experts say many have tackled rising health care costs, with limited results.

Read Article arrow

William McGivney, PhD (Posted: February 06, 2018)

quotesOne tweet struck me in this story about the update on Amazon, JP Morgan and Berkshire and it is: • “I want there to be something to bring healthcare costs down.” Well, as a whole, general health care costs will never come down as I have written over the years. Healthcare technology innovations are always expensive. Many of these technologies turn out to be add-on interventions (monotherapy going to combination) or make more lines of therapy available by becoming first line (like anti-PD-1s and anti PD-L1s) pushing down previous first line agents to second line and then others to third line, etc. Importantly, our population of potential patients continues to get older. Actually, the most insightful comment came from Dr. Warren Buffet (honorary MD for my convenience) as the quote focused on working to “check the rise in health costs”. As such, whoever wrote the quote understands that the goal is to check or slow the rate of rise of healthcare expenditures. This is the best that we can hope for and aim for. quotes

Add Comment 2 Comment

Meet the Editorial Board

Prostate Cancer
member photo
Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

Community Oncology
member photo
Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
member photo
Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
member photo
H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
member photo
Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
member photo
Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
member photo
Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
member photo
Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
member photo
Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
member photo
Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
member photo
Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
member photo
Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
member photo
Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
member photo
William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
member photo
William McGivney, PhD

National Health Policy Expert...

Payer
member photo
Winston Wong, PharmD

President, W-Squared Group...